Individual provider Active NPI

Gino Inverso, MD, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Woodbury Heights, NJ
National Provider Identifier
1215323944
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
1215323944 Issued in NJ
Practice address
992 Mantua Pike Ste 302
Woodbury Heights, NJ 08097-1249
Phone
(856) 845-1341
NPI assigned
Apr 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X MD474313 PA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 1215323944 NJ Primary

Addresses

Primary practice location

992 Mantua Pike Ste 302
Woodbury Heights, NJ 08097-1249

Mailing address

992 Mantua Pike Ste 302
Woodbury Heights, NJ 08097-1249
Phone (856) 845-1341

Other practice location 1

467 Pennsylvania Ave Ste 106
Fort Washington, PA 19034-3420
Phone (215) 591-3590

Other practice location 2

46 Blacksmith Rd Ste Dreams
Newtown, PA 18940-2064
Phone (215) 579-1525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 19, 2024 through Dec 19, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
1215323944NJMDOral and Maxillofacial Surgery (Dentist)
MD474313PAMDOral & Maxillofacial Surgery (D.M.D.)

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1215323944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "992 MANTUA PIKE STE 302",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971249",
            "telephone_number": "856-845-1341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "992 MANTUA PIKE STE 302",
            "city": "WOODBURY HEIGHTS",
            "state": "NJ",
            "postal_code": "080971249",
            "telephone_number": "856-845-1341"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "467 Pennsylvania Ave Ste 106",
            "address_purpose": "LOCATION",
            "city": "Fort Washington",
            "state": "PA",
            "postal_code": "190343420",
            "country_code": "US",
            "telephone_number": "215-591-3590",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "46 Blacksmith Rd Ste Dreams",
            "address_purpose": "LOCATION",
            "city": "Newtown",
            "state": "PA",
            "postal_code": "189402064",
            "country_code": "US",
            "telephone_number": "215-579-1525",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INVERSO",
        "first_name": "GINO",
        "name_prefix": "Dr.",
        "credential": "MD, DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-09",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "PA",
            "license": "MD474313",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "1215323944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury Heights, NJ

Sources for this page

Verify at the official NPI Registry.